NSG 604 Module 8 Discussion 1: Population Health

NSG 604 Module 8 Discussion 1: Population Health

NSG 604 Module 8 Discussion 1: Population Health

Module VII: Population Health

Introduction

Assessing the population involves the study of the distribution and determinants of disease in populations with the intent to understand, cure, and/or prevent disease. These conditions usually occur when the problem is unexpected, a timely response is demanded, or epidemiologists are required to solve the problem but do not start with a hypothesis. Primarily, there has to be a need to protect the population and a determination of sufficient information available to take action.

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Field investigations of populations encompass several activities including:

obtaining information,

collecting specimens,

performing physical assessments,

identifying the natural course of a disease (from a localized disorder with a common source to outbreaks spread from person to person), and

writing reports.

Establishing the definition of a case involves the use of standard clinical criteria to determine whether a person has a disease and guarantee consistent diagnoses under all circumstances. In addition, unrecognized or unreported cases, and their contacts must be identified and evaluated.

The Center for Disease Control and Prevention (CDC) has listed several definitions for cases including:clinically compatible cases,

confirmed cases,

epidemiologically linked cases,

laboratory confirmed cases,

probable cases, and

suspected cases.

Once cases have been identified they must be oriented to person characteristics associated with the disease, locations, and geographic extent of the disease, and time of onset which provides an epidemic curve about the disease outbreak.

Objectives

Upon completion of this module the student will be able to:

compare and contrast common-source epidemics and propagated epidemics

define disease clusters and cluster investigation

discuss the process for investigating clusters.

Define field epidemiology.

Describe the steps of a field investigation

Formulate epidemiologic questions that may be helpful in a field investigation

Classification of Epidemics

There are two classifications of epidemics determined once the mode of transmission of a disease has been identified.

The common-source epidemic involves a mass infection from exposure to a common source, while the propagated epidemic is spread gradually from person to person. A combination of the two is called a mixed outbreak.

When classifying an epidemic, the epidemiologist should ask the following questions:

Is the outbreak from a single source or a single-point exposure?

Is disease spread from person-to-person?

Is there continued exposure to a single source?

Is the outbreak from multiple sources and/or exposures?

Is the outbreak airborne? Behaviorally or chemically caused?

Does the outbreak involve multiple events or exposures?

Are the sources of infection from unapparent sources?

Is there a vector involved in transmission?

Is there an animal reservoir of infection? (Merrill, 2021, p.210)

Those who have been exposed to the disease, including ill and well, mildly ill, and asymptomatic individuals must have exposure histories examined. A variety of findings must be assessed and evaluated, and a search made for the source of infection. With this information, the epidemiologist develops hypotheses about the source and transmission of the outbreak and tests these hypotheses. If the information cannot confirm the hypothesis, more information must be gathered, or the hypothesis rejected. The epidemiologist prepares reports in an appropriately illustrative manner and presents these to officials whose job it is to warn the public at risk as well as implement prevention and control measures.

A disease cluster is an unusual aggregation, real or perceived, of health events that are grouped together in time and space and are reported to a health agency. Such clusters usually result from some specific process (natural disasters, worksite conditions, biologic or chemical contaminants, or political/social upheaval) rather than an event that happened by chance. Cluster investigations are conducted to confirm a specific issue and whether the cases exceed expectations. See table 10-4 for some environmental exposures related to disease clusters.

Sentinel events, defined as unexpected diseases or disorders known to result from specific, recognized causes, differ from disease clusters in which there are occurrences of seemingly unexpected diseases for which no immediately recognized cause exists.

Field epidemiology is applied when a problem arises that is unexpected, and the public wants a prompt response. Epidemiologists go out into the locale to conduct a limited investigation that supports an early response plan. Food-borne illnesses are often investigated in this way. See Table 10-1, and the sections that follow, for the steps in conducting a field investigation.

Welcome to week 7

Readings

Merrill: Chapter 10

Disease clusters: disease clusters.pdf.

Review this website using a fictitious town, called Epiville, to learn about epidemiology and outbreak management. All the topics are great and will support your learning epidemiology through scenarios so check them out!

Complete the SARS Outbreak Module One to answer our discussion question this week.

Epiville (columbia.edu)

Discuss It

Module VII
Discussion 1

Briefly share what the findings were at the end of SARS outbreak module one. What do you think you should do with your findings at the end of the outbreak investigation? In answering this question, consider the following: (1) the importance of information flow between public health agencies, (2) possible barriers to sharing data, (3) various ways to communicate your findings to other agencies and then to the public. Review the resources below for ideas.

How to Convey Changing Risks | National Institutes of Health (NIH)

Public Participation Guide: Tools to Inform the Public | US EPA

Post your initial response by Wednesday at midnight. Respond to two students by Saturday at midnight. All responses should be a minimum of 300 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to the Grading Rubric for Online Discussion in the Course Resource section.

Module VII: Discussion 1

Post your initial response by Wednesday at 11:59 PM EST. Respond to two students by Saturday at 11:59 PM EST. The initial discussion post and discussion responses occur on three different calendar days of each electronic week. All responses should be a minimum of 300 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and referenced. A minimum of 2 references are required (other than the course textbook). These are not the complete guidelines for participating in discussions. Please refer to the Grading Rubric for Online Discussion found in the Course Resources module.

Special Guidance on APA formatting in Discussion Posts

APA formatting is required in discussion posts with the following two exceptions (due to limitations with the text editor in LIVE): double line space and indent 1/2 inch from the left margin. Discussion posts will NOT be evaluated on those two formatting requirements. All other APA formatting guidelines should be followed. For example, in-text citations must be formatted with the appropriate information and in the correct sequence (Author, year), reference list entries must include all appropriate information following guidelines for capitalization, italics, and be in the correct sequence. Refer to the APA Publication Manual 7th ed. for each source type’s specific requirements. Please let your instructor know if you have any questions.